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A 10-year-old child presents with peri-umbilical pain, rebound tenderness, nausea, and fever up to 102°F (38.9°C). The pain prevents him from standing up straight. Which of the following should a nurse anticipate first?
An infant is admitted with tonic-clonic movement of the lower extremities. The most likely etiology of the seizure is:
A patient with suspected abdominal compartment syndrome has a bladder pressure of 8 mmHg. Which of the following actions should the nurse take first?
The positive inotropic effects of dobutamine (Dobutrex) at 7 mcg/kg/min will produce an increase in which of the following hemodynamic parameters?
A child with a right pulmonary contusion is intubated and ventilated. When positioned with the affected side down, O₂ saturation drops. The most likely cause is:
When evaluating the effectiveness of a new skin care protocol, a nurse should assess the:
A transgender adolescent requests to be addressed by preferred name/pronouns, different from medical record. What is the best response?
A 2-month-old previously healthy infant is admitted for seizures. Lab values include:
Na: 119 mEq/L (low)
K: 4.8 mEq/L (normal)
Cl: 92 mEq/L (low)
Glucose: 78 mg/dL (normal)
Head CT: Normal
The nurse’s most appropriate action is to:
A patient has visitors whose loud talking and laughing disrupts other patients and visitors in the ICU. Which of the following is the most effective way for a nurse to address this situation?
A 17-year-old on home peritoneal dialysis has new-onset fever and abdominal pain. Dialysate WBC is 185. What order should the nurse anticipate?
The primary function of an institutional ethics committee in the critical care area is to:
A child is admitted following chest trauma, and a small pneumothorax (less than 10%) is noted. A nurse should anticipate which of the following?
To evaluate effectiveness of transvenous ventricular pacing, the ECG should show a pacing spike followed by:
An adolescent with recurrent leukemia expresses a desire to die peacefully. Weeks later, the patient is critically ill and the parents ask whether to escalate care. The nurse’s most appropriate response is:
A child with hepatic failure received volume replacement. Following this therapy, laboratory tests reveal:
PT: 14 sec
PTT: 40 sec
Hct: 36%
Albumin: 3.5 g/dL
Before the patient undergoes a closed liver biopsy, further replacement should include:
An infant in need of a transfusion of PRBCs has only one IV access site with maintenance fluids infusing. After receiving orders to hold the maintenance fluids and administer PRBCs, the nurse should be sure to monitor which of the following?
A child is heading to the OR for internal injuries. The parents refuse blood products due to religious beliefs. What should the nurse do first?
An infant presents with poor feeding and a blood glucose level of 50 mg/dL. A nurse should assess for which of the following symptoms?
A child with ALL presents 1 week after chemo, fatigued and hypothermic. Initial expected nursing intervention?
A school-age child is admitted in acute respiratory failure requiring mechanical ventilation. Endotracheal aspirate Gram staining is positive for an acid-fast bacillus. The nurse’s initial action should be to:
The relationship between the family of a long-term patient and ICU healthcare providers has become strained. A nurse should first:
A child has fever, chills, back pain, elevated WBC and ESR, and abnormal urinalysis. After IV fluids and antibiotics, what procedure should be anticipated?
A school-aged patient who was admitted with an acute asthma exacerbation has improved and is now ready for transfer to the floor. In preparation for discharge, the nurse should evaluate:
A patient is postoperative day 1 from a laparotomy for appendicitis. Which intervention best prevents surgical wound infection?
Twenty-four hours after a severe burn and inhalation injury, a child develops increased tachypnea and desaturation. The most likely cause is:
Which of the following interventions is most effective in preventing pulmonary vasospasm in an infant with persistent pulmonary hypertension of the newborn (PPHN)?
A 6-year-old child is admitted following ingestion of an unidentified substance. Assessment reveals:
BP: 120/84
HR: 190
RR: 44
ECG: Sinus rhythm with occasional PVCs
Dilated pupils
Dry mucous membranes
Disorientation
Urinary retention
These findings are consistent with ingestion of:
The parents of a teenager with terminal neuroblastoma are preparing to withdraw life-sustaining treatment. The parent states, "I would like their sibling to be here, but I’m not sure if that is a good idea.” Which of the following is the best response by a nurse?
A 9-year-old patient with a history of tachycardia and syncope is connected to a monitor that shows a HR of 190, with regular P-P and R-R intervals. The patient is awake, crying, anxious, and has a BP of 94/60. Which of the following is the initial nursing intervention?
A child with spinal muscular atrophy type I (SMA) is admitted with respiratory syncytial virus (RSV). The child is hypotonic and tachypneic with moderate subcostal retractions and nasal flaring. After suctioning, the child’s respiratory status does not improve. Arterial oxygen saturations are 93% with an FiO₂ of 50%. Which of the following interventions should the nurse anticipate next?
A 4-day-old infant presents with lethargy, vomiting, acidosis, and has a seizure upon arrival. What is the most likely diagnosis?
A child with short bowel syndrome presents with fever, dehydration, and weight loss. To ensure nutrition, the nurse should anticipate:
After a disaster drill, several issues related to notification of personnel and their role in the disaster were revealed. Which action should be done first?
A child who nearly drowned received CPR, was resuscitated quickly, and regained consciousness. What should the nurse anticipate?
An infant has hypovolemic shock from severe diarrhea. Which of the following assessments demonstrates adequate tissue perfusion following fluid resuscitation?
Capillary Refill
Urine Output
CVP
BP
a. 2 sec
0.5 ml/kg/hr
2 mm Hg
84/50
b. 3 sec
0.5 ml/kg/hr
6 mm Hg
72/44
c. 3 sec
1.2 ml/kg/hr
4 mm Hg
72/48
d. 2 sec
1.2 ml/kg/hr
8 mm Hg
80/54
TESTED 07 Jun 2025